A vaginal fibroleiomyoma in a
ten-year-old spayed pug dog
F. Brutinel1, S. Egyptien1, M. Hamon1, M. Heimann2, S. Noël1 and S. Deleuze1
1University of Liège, 2Veterinary pathology laboratory, Anapet E-mail: flore.brutinel@uliege.be
Case
• Ten-year-old pug, spayed two years before
• Referred for a bleeding vaginal mass protruding intermittently from the vulva (Figure 1), tenesmus, dysuria progressing to anuria
• No report of signs of heat after ovariectomy or exogenous estrogen administration
• Antimüllerian hormone and progesterone assayed a few days before: 0.01 and 0.1ng/ml respectively
Complementary exams
• Vaginal cytology: no sign of estrogen impregnation
• Endoscopic vaginal examination: single, painful mass with areas of calcification and necrosis, measuring 5x5 cm, involving the dorsal wall of the caudal vagina
• Abdominal ultrasonography: No ovarian tissue identified - Liquid dilatation of the vagina, hemorrhagic vulvar discharge occurred after the procedure - No evidence of abdominal metastasis
→ No evidence of residual ovarian tissue
Treatment and outcome
• Emergency surgical excision due to complete urethral obstruction
• Resection through an episiotomy and a partial thickness incision around the pedicle - Vaginal mesh and urinary catheter left in situ during 48h (important diffuse bleeding)
• Good outcome
Purpose: Description of a case of benign vaginal tumour in a spayed bitch. Investigation for potential causes of estrogen impregnation and research of estrogen receptors on the resected mass by immunohistochemistry.
ESDAR Conference 2019 19-22 September 2019 St. Petersburg (Russia)
Histological diagnosis and research of estrogen receptors by immunohistochemistry
• Fibroleiomyoma with some atypical areas with anysocaryosis
• Estrogen receptors αER 1D5 found by immunohistochemistry in the tumor, including atypical areas, healthy vaginal epithelium and smooth muscles (Figure 3)
Conclusion
We report a rare case of a benign vaginal tumor in a spayed bitch without evidence of ovarian remnant syndrome. This tumor still has ER. Vaginal examination before late neutering should be recommended to detect any
vaginal mass.
Discussion
• Vaginal and vulval tumors :
• 2.4-3% of all canine tumors, 73% of them are benign - Vaginal leiomyomas are usually found in intact bitches
• Influence of ovarian hormone strongly suspected: ovariohysterectomy recommended at the time of excision of the vaginal mass
• E2 receptors present in surface epithelium, stroma and smooth muscle cells of the healthy vaginal tissuea
• Half of the benign vaginal tumors have estrogen receptors and 84% progesterone receptorsb
• In this reported case:
• no evidence of residual ovarian tissue
• the vaginal mass is strongly suspected to have been already present at the time of ovariectomy
• less likely, the mass may have appeared and grown after sterilization in absence of estrogen stimulation, even if estrogen receptors were present as it is suspected that they may persist without estrogen stimulation.
Figure 1: Perineal swelling and vaginal mass protruding from the vulva.
Figure 2: Vaginal mass after excision.
Figure 3: Immunohistochemistry for estrogen receptors. The tumor cells show nuclear
immunolabelling with anti-ER antibody. X100.
References:
a Vermeirsch H., et al, Immunolocalization of sex steroid hormone receptors in canine vaginal and vulvar tissue and
their relation to sex steroid hormone concentrations. Reprod Fertil Dev. 2002;14(3-4):251-8.
b Millán Y., et al, Steroid receptors in canine and human female genital tract tumours with smooth muscle
